AccountId: 011433970860
ContactId: 8fe63b3a-b256-432e-866b-655157e22854
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 844869 ms
Total Talk Time (AGENT): 169743 ms
Total Talk Time (CUSTOMER): 212613 ms
Interruptions: 1
Overall Sentiment: AGENT=0, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/8fe63b3a-b256-432e-866b-655157e22854_20250226T17:54_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, this is [PII] calling from provider's office. uh to connect you.
[AGENT][NEUTRAL] OK [PII], I can help you with the claim. Can I please get your callback number?
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] Thank you. And what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh yes. The patient ID is [PII]. The patient name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, let me pull up that policy.
[AGENT][NEUTRAL] And what was the patient's name again?
[CUSTOMER][NEUTRAL] Uh yes. The patient name is uh [PII].
[AGENT][NEUTRAL] OK, I do not show a Camre on this policy.
[CUSTOMER][NEUTRAL] Just give me a second.
[CUSTOMER][NEUTRAL] Yeah, it is [PII].
[AGENT][NEUTRAL] OK, I find I find another name. Do you have [PII]?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] And may I have the date of service please?
[CUSTOMER][NEUTRAL] Yes, data service I have here is [PII]. The total charge amount of uh $278 even.
[AGENT][NEUTRAL] OK, and what is the charge amount after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] Yeah, it is $241.37.
[AGENT][NEUTRAL] Thank you. And the name of the facility you're calling from, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes. The facility name is Ana Clinic.
[AGENT][NEUTRAL] OK, I'm gonna put you on a brief hold while I look up this claim for us, Miss [PII] and I'll be right back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me [PII]. I did search on that data service and I do not find a claim on file with the amount that you have given me.
[CUSTOMER][NEUTRAL] Just give me a second. I'll help you with that details.
[CUSTOMER][NEUTRAL] Just for a second.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Just a second.
[CUSTOMER][NEUTRAL] Yeah, just give me a second.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, the total charge amount is, uh, actually $278 even after the primary rate, the remaining balance is $241.37.
[AGENT][NEUTRAL] No, ma'am, I do not find a claim on file with those amounts.
[CUSTOMER][NEUTRAL] Uh, yeah. Can you please help me with the mailing address?
[AGENT][NEUTRAL] Yes, the address is [PII].
[AGENT][NEUTRAL] That's in [PII] City, [PII], and the zip code code is [PII].
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah, can you please help me with the eligibility and term?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] The effective date is [PII] and the policy is still active.
[CUSTOMER][NEUTRAL] [PII] with no term date. And uh can you please spell out your name for me?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII], right? Is it [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, just give me a. It's story, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, just give me a second.
[CUSTOMER][NEUTRAL] You want the next one, same patient, uh but they need a service.
[AGENT][NEUTRAL] OK, what's the next day service?
[CUSTOMER][POSITIVE] Yeah. Just give me a second so that I can help you with the details.
[CUSTOMER][NEUTRAL] Yeah, wait a second.
[CUSTOMER][NEUTRAL] Uh, yes, the next date of service I have here is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh the total charge.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The total charge amount I have here is $558 even after the primary process and paid, the remaining balance is $110.92.
[AGENT][NEUTRAL] OK, and is it for the same provider?
[CUSTOMER][NEUTRAL] Uh, yes, the actually the same.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on hold while I look this one up. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding. So looking on data service for [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] Yeah, just give me a second. Uh, she'll want the next one, same patient, uh, but.
[AGENT][NEUTRAL] The data service is going to be the same?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh, no. The data service is going to be different. The next data service I have here is [PII].
[AGENT][NEUTRAL] And what is the charge amount?
[CUSTOMER][NEUTRAL] Uh, yeah. The total charge amount is $340 even.
[AGENT][NEUTRAL] And then the charges after primary paid their part?
[CUSTOMER][NEUTRAL] It is $274.28.
[AGENT][NEUTRAL] OK, and is it for [PII]?
[CUSTOMER][NEUTRAL] Uh, just give me a second. I'll confirm you whether it is.
[CUSTOMER][NEUTRAL] The same or not. Yeah, it is clinic.
[AGENT][NEUTRAL] OK, alright, I'm gonna put you on a brief hold I'll be right.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you, Miss [PII]. So looking on this state of service of [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] Officially want the next date of service, same patient.
[AGENT][NEUTRAL] OK, what is that data service?
[CUSTOMER][POSITIVE] Thank you so much for your patience. The next date of service I have here is [PII]. The total charge amount of $691.95.
[AGENT][NEUTRAL] OK, and then what's the charges after primary?
[CUSTOMER][NEUTRAL] Yeah, it is $281.44.
[AGENT][NEUTRAL] And same facility Oshner.
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] OK, a brief hold again I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Miss [PII] looking on data service of [PII], I do not find a claim on file for the amount you have given.
[CUSTOMER][NEUTRAL] Uh, for the, your uh for the date of [PII]. Um, no.
[AGENT][NEGATIVE] Not for the amount that you've given.
[CUSTOMER][NEUTRAL] Uh, just give me a second. The next state of service is the same, but, uh, the total charge amount is different. Let me help you with that details. Just give me a second.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The rate of service is [PII], but the total charge amount is $345.45.
[AGENT][NEUTRAL] OK, and then what is the balance after primary?
[CUSTOMER][NEUTRAL] It is $239.24.
[AGENT][NEUTRAL] OK, and is it also for [PII]?
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] OK, brief hold I'm gonna look it up again for you. I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you, um, Miss [PII], so looking on data service again for [PII], I do not find a claim on file for the amount you have given.
[CUSTOMER][NEUTRAL] Yeah. The next data of service I have uh same data service, but the total charge amount is different.
[CUSTOMER][NEUTRAL] Let me confirm with the charge amount. It is $274 and after the primary process that the remaining balance is $222.31.
[AGENT][NEUTRAL] And for the same facility?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can tell you that one is not on file either for that same date of service for your facility or the amount given.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, just give me a second.
[CUSTOMER][POSITIVE] Yup, thank you so much. Have a nice day.